Injuries are the worst thing one would have to deal with in the gym, and working around any number of tweaks and tears can be nerve wracking. Notably, the lower back is one of the regions of the body that’s most prone to injury due to lifting, making it one of the most common areas to sideline a lifter. It would certainly be useful to have a guide of back rehab do’s and don’ts.

But first, here comes a disclaimer:

This is not a medical dissertation, and the phase of recovery we’re most interested in here would be outside of the rehabilitative portion. In other words, a lifter who’s sustained a horrible injury requiring surgery or extensive rehab isn’t the target of this article and would be best suited finding a medically licensed professional and listening to a clinician’s advice regarding a suitable course of action.

For us, a “bad back” refers to recurrent tweaks, chronic pain, or weakness that can be debilitating when sustained, but doesn’t put you in a wheelchair or the operating table. Such issues can come from things like muscle strains or facet inflammations, or a history of instability in the lumbar region.

So, having a injured back sucks. But it’s important to start things off with a tip that looks at things a bit more holistically.

Back Rehab Tip 1: How Are Your Hips and Glutes?

If your back is prone to injury, chances are, too much is being asked of it. The first place I like to look on clients would be the hip region. If there’s poor hip mobility, the lumbar region will likely end up over-rotating and taking on more loading in compound movements due to poor strength in the glutes (a main hip extensor). Restoring hip mobility can be achieved both actively and passively depending on the nature of the mobility drill you choose. Here’s an example of each:

This definitely puts the hip through a good range of motion, and would classify best as a dynamic stretch, since the quads and groin are being put into a lengthened position on each rep, and the body remains in motion.

This challenges the end ranges of the hips’ ability to flex, internally rotate, and extend as they go through the pattern, and is a good example of a mobility drill, with the goal of improving active range of motion.

Adding movements in both categories to your routine, while focusing on glute-focused strength exercises that are more isolated in nature (like hip thrusts, single leg glute bridges, clamshells, and glute kicks), can be a hidden key to alleviating chronic back pain and recurrent tweaks.

Back Rehab Tip 2: Don’t Pair Compressive Movements

Whether you’re doing them as a superset, or as back-to-back straight-set movements in your workout order, it’s important to know what moves may be doing more harm than good in the big picture where recovery and low back health is concerned. Keep in mind, this may not be too much of a problem for someone with a fully healthy spine, but for someone who’s been in and out of the chiropractor’s office with pain management, this is an underrated tip worth considering.

Movements like deadlift, squat, and overhead press variations all have one thing in common: They present downward compressive forces on the lumbar spine. Compounding that sensation with back to back exercises (especially if there’s no time to rest and recover between them) can be a recipe for discomfort despite the good utility of each movement mentioned. Break things up by choosing decompressive movements like dips, pulldowns, leg raises or pull ups to pair them with. Alternatively, movements performed from a supine (laying face-up) position are smart choices to give the spine a chance to recover within the workout.

Back Rehab Tip 3: Think Isometrics

Isometrics sound boring, and maybe even a bit too easy, but they provide countless benefits.

First of all, they provide the least risk for injury. Almost always, injuries happen when the skeleton is changing position under load. This is true in lifting injuries as well as injuries on the athletic court or field. When movement is eliminated from the equation, the chances of getting hurt while exerting maximally are drastically reduced. This should be music to the ears of a person with a bad back looking to strengthen it using movements like deadlifts or bentover rows. Now you can lift “heavy” without the risk factor. Here’s an example you can duplicate using a deadlift, blocked by the safety pins.

Want to explore a different segment of the lift? Simply raise the pins higher up to exploit that part of the pull.

Since you’re maxing out your energy systems, starting with sets of 15-20 seconds would be ideal. But the goal is to work very hard. In truth and theory, trying to move your ZERO rep max should be more difficult than successfully moving your ONE rep max. It’s all based on what you put into it.

Back Rehab Tip 4: Ditch the Twisting (for Now)

If your low back is lit, chances are, you don’t know how to rotate well. Here’s the truth: rotation should dominantly occur in the segments above your lumbar spine (your thoracic region). If you don’t have great mobility through those segments, the lumbar segments – which should not rotate much at all – will be called upon to access the range of motion. This is bad news bears for back health.

With that said, loaded athletic movements like Russian twists, rotational med ball throws, or oblique twists may be great for the core, but may have collateral damage they’re placing on the low back. Hit the obliques hard by instead thinking about anti-rotational patterns that keep the trunk still and stable. They’ll help improve the function of the trunk. Off bench oblique work, suitcase deadlifts, and plate transfer planks are good examples of these patterns.

Back Rehab Exercises You Should Be Doing

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